Predictive factors of mortality in pediatric patients with acute renal injury associated with sepsis

Abstract

The risk factors for mortality in children with acute kidney injury were associated with sepsis severity.

Predictors and outcome of acute kidney injury after non-cardiac paediatric surgery

“…The outcome of care was, however, worse among patients who developed AKI when compared to those without AKI; mortality was recorded only among patients who developed AKI. Similar findings were reported by Riyuzo et al [27] who studied 77 children with AKI in the Paediatric Intensive Care Unit over a 5-year period and found that 73% of the patients with AKI recovered over the first week of diagnosis and the overall mortality was related to the severity of renal dysfunction. Others have reported similar effect of AKI on postoperative mortality in children [31][32][33][34].…”

“…Sepsis on its own is a major cause of AKI in children [25,26]. It has been shown by other authors to predict the occurrence of AKI [13] or mortality from AKI [27]. Sepsis has been shown in experimental animals to lead to renal hypoperfusion and reduction in renal blood flow [26, 28].…”

Sepsis-associated acute kidney injury – is it possible to move the needle against this syndrome?

“… 3 For these reasons, sepsis and AKI go “hand-in-hand” – and likely synergistically contribute to the quick, downward spiral of patients suffering both injury syndromes. Riyuzo et al 5 in their study of children with SSAKI, observed a clinical parallel to these pathophysiologic findings. In their study, the children with SSAKI were young (median 4 months), were diagnosed early (first day of admission to the intensive care unit), and suffered severe injury (>75% pRIFLE class I–F and stage 2–3).…”

“… 4 Together, unfortunately, sepsis and AKI synergize into the “worst of both worlds” – inciting a litany of negative host responses and ultimately leading to poor patient outcome. In this issue of Jornal de Pediatria , Riyuzo et al 5 report data on the predictive factors of death in patients with sepsis associated AKI. In their retrospective evaluation of 77 children with sepsis and AKI, the rate of severe AKI (pRIFLE stage I–F and/or stage 2–3 were both over 75%) and the overall mortality rate was substantial (33.7%).…”

Cefepime Pharmacokinetics in Critically Ill Pediatric Patients Receiving Continuous Renal Replacement Therapy

“…This report represents the first published PK data for cefepime in critically ill pediatric patients receiving a range of CVVHDF clearances. Sepsis represents a significant source of morbidity and mortality in pediatric patients (17), with patients on CRRT demonstrating even higher mortality rates (18)(19)(20). With numerous reports suggesting improved patient outcomes by achieving more aggressive PD targets (10)(11)(12)(13)(14), optimal dosing data in pediatric patients on CRRT are vital.…”